Ritexone

Description

Ritexone Injection

Generic Name: Ceftriaxone

Manufacturer: Micro Labs Ltd. (Available in Nepal)

Uses

Ritexone Injection is an antibiotic used to treat various bacterial infections, including:

• Serious Infections: Pneumonia, meningitis, septicemia (blood poisoning), bone and joint infections, and complicated intra-abdominal infections.
• Other Infections: Acute otitis media (middle ear infection), Lyme disease, typhoid fever, pelvic inflammatory disease, skin and skin-structure infections, respiratory tract infections, urinary tract infections, gonorrhea, and Chlamydia infection.
• Prophylaxis: Prevention of surgical infections.

Dosing Information

Ritexone Injection can be administered intravenously (IV) or intramuscularly (IM).

Adult Dosing

• For most susceptible infections (IV/IM): 1-2 g daily. For severe infections, the dose can be increased up to 4 g daily.
• Complicated, mild-to-moderate, community-acquired Intra-abdominal Infections (IV): 1-2 g daily as a single dose or divided every 12 hours for 4-7 days, in combination with metronidazole.
• Meningitis (IV): 2 g every 12 hours for 7-14 days.
• Acute Uncomplicated Pyelonephritis (IV): 1-2 g once daily.
• Typhoid Fever (IV): 2 g once daily for 14 days.
• Surgical Prophylaxis (IV): 1 g administered 0.5-2 hours before the surgical procedure.
• Uncomplicated Gonococcal Infections (Pharynx, Cervix, Urethra, or Rectum): 250 mg IM once plus azithromycin 1 g orally once (preferred) or alternatively, doxycycline 100 mg orally every 12 hours for 7 days.
• Pelvic Inflammatory Disease (IM): 250 mg as a single dose with doxycycline, with or without metronidazole, for 14 days.

Child Dosing

• For most susceptible infections (IV, IM): 50–75 mg/kg/day, with a maximum dose of 2 g/day, given every 24 hours.
• Acute Otitis Media (IM): 50 mg/kg, with a maximum dose of 1 g, given in 1–3 doses every 24 hours.
• Meningitis: 100 mg/kg/day, with a maximum dose of 4 g/day, given every 12 hours.

Dosing for Kidney Problems

If you have kidney impairment, your doctor will need to adjust your dose.

• Creatinine Clearance (CrCl) less than 10 ml/min: The maximum dose is 2 g daily.

Administration

• Intravenous (IV) Administration: Infuse intermittently over 30 minutes.
• Intramuscular (IM) Administration: Inject deep into a large muscle mass.

Important Considerations

Do Not Use If:

• You have a hypersensitivity (allergy) to cephalosporin antibiotics.
• You are a hyperbilirubinemic neonate (newborn with high bilirubin levels).
• Crucially: Do NOT use calcium or calcium-containing solutions/products with or within 48 hours of ceftriaxone administration. This combination carries a potentially fatal risk of calcium-ceftriaxone precipitate formation in the lungs and kidneys.

Use With Caution If You Have:

• A history of penicillin allergy.
• Severe renal impairment (kidney problems).
• Are pregnant or breastfeeding.
• Are at risk of superinfection (new infection occurring during treatment for an existing infection).

Pregnancy & Breastfeeding:

• Pregnancy: Use with caution.
• Lactation: The drug enters breast milk in low concentrations; use with caution.

Drug Interactions

• Aminoglycosides: May increase the nephrotoxicity (kidney damage) of aminoglycosides.
• BCG, Typhoid Vaccine, Sodium Picosulfate: May diminish their therapeutic effect.
• Vitamin K Antagonists (e.g., Warfarin): May increase their anticoagulant (blood-thinning) effect.
• Probenecid: May increase the serum level of Ceftriaxone.

Potentially Fatal Interaction:

• Calcium-containing IV solutions: Administering Ceftriaxone with IV solutions containing calcium can cause the precipitation of crystalline material in the lungs and kidneys, which can be fatal.

Possible Side Effects

Very Common (>10% of people):

• Induration (hardening) after IM injection (5-17%) – Note: The provided data states >10% for induration, but then specifies 5-17%. It’s best to consider the 5-17% as the accurate range.

Common (1-10% of people):

• Eosinophilia (6%)
• Thrombocytosis (5%)
• Diarrhea (3%)
• Elevated hepatic transaminases (liver enzymes) (3%)
• Leukopenia (low white blood cell count) (2%)
• Rash (2%)
• Increased blood urea nitrogen (BUN) (1%)
• Induration at IV site (1%)
• Pain (1%)

Less Common (<1% of people):

• Agranulocytosis (severe reduction in white blood cells), anaphylaxis (severe allergic reaction), anemia, basophilia (increased basophils), bronchospasm, candidiasis (yeast infection), chills, diaphoresis (sweating), dizziness, dysgeusia (taste disturbance), flushing, gallstones, glycosuria (sugar in urine), headache, hematuria (blood in urine), hemolytic anemia (red blood cell destruction), increased alkaline phosphatase or bilirubin, increased creatinine, jaundice (yellowing of skin/eyes), leukocytosis (increased white blood cells), lymphocytosis (increased lymphocytes), lymphopenia (decreased lymphocytes), monocytosis (increased monocytes), nausea, neutropenia (low neutrophils), phlebitis (vein inflammation), prolonged or decreased prothrombin time (PT), pruritus (itching), renal stones (kidney stones), serum sickness (allergic reaction), Stevens-Johnson syndrome (severe skin reaction), thrombocytopenia (low platelet count), urinary casts, vaginitis, and vomiting.

Potentially Life-Threatening Side Effect:

• Pseudomembranous colitis (severe colon inflammation).

How Ritexone Works (Mechanism of Action)

Ceftriaxone, the active ingredient in Ritexone, works by binding to one or more of the penicillin-binding proteins (PBPs) found in bacteria. This action inhibits the final transpeptidation step of peptidoglycan synthesis, which is a crucial process in the formation of the bacterial cell wall. By preventing the biosynthesis and assembly of the cell wall, Ceftriaxone ultimately leads to bacterial cell death.

Disclaimer: This information about Ritexone Injection is for general knowledge and is not intended for diagnosis, medical advice, or treatment. It should not be considered a substitute for the exercise of professional judgment.